Impact of the new <scp>IADPSG</scp> gestational diabetes diagnostic criteria on pregnancy outcomes in Western Australia

Laafira, Aminath; White, Scott W.; Griffin, Christopher; Graham, Dorothy

doi:10.1111/ajo.12394

Cited by 44 publications

(28 citation statements)

References 22 publications

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“…In a recently published retrospective Australian study, adoption of the new criteria would increase the number of women with GDM but result in improvements in perinatal morbidity and an opinion that the benefits would justify the increase in healthcare workload. 20 There were no recorded differences in the caesarean section rate.…”

Section: Discussionmentioning

confidence: 86%

The prevalence of hyperglycaemia in pregnancy in Australia

Moses

Wong

Lambert

et al. 2016

Aust NZ J Obst Gynaeco

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Background: The Australasian Diabetes in Pregnancy Society (ADIPS) has recently endorsed the World Health Organization (WHO) terminology and classification of hyperglycaemia in pregnancy. The prevalence is likely to increase, but no prospective data are available for a representative Australian population. Aims: To determine the prevalence of hyperglycaemia in pregnancy (HIP) using results from both the public and private sectors in a population that has a similar ethnicity to the overall Australian population. Material and Methods:The results of all pregnancy oral glucose tolerance tests (POGTT) in the public sector and by a dominant private pathology provider in a major city have been prospectively collected for a three-year period and analysed using the ADIPS (WHO) criteria. Results: The prevalence of hyperglycaemia in pregnancy (HIP) was 13.1% with diabetes mellitus in pregnancy (DIP) being 0.4% and gestational diabetes mellitus (GDM) being 12.7%. Conclusion:The new criteria will diagnose about one-third more women with GDM than the previous ADIPS criteria. This will have resource and health implications. Focussed local health economic data will be important.

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Section: Discussionmentioning

confidence: 86%

The prevalence of hyperglycaemia in pregnancy in Australia

Moses

Wong

Lambert

et al. 2016

Aust NZ J Obst Gynaeco

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“…Regarding concerns related to workload and workforce issues, Australian publications have predicted and indeed shown an increase of between 20 and 30% 9,10 in GDM cases with these new criteria, whilst others have shown lesser increases (12.5 and 20%) and indeed no significant change in prevalence in Indigenous women in Cape York. [11][12][13] Regarding the concern about first trimester GDM diagnosis, a recent statement by IADPSG 14 recommends against the use of a fasting glucose threshold ≥ 5.1 mmol/L for GDM diagnosis in early pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Survey on testing for gestational diabetes mellitus in Australia

Flack

Ross

2016

Aust NZ J Obst Gynaeco

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We surveyed members of National Association of Diabetes Centres (NADC) assessing use of new Australasian Diabetes In Pregnancy Society (ADIPS) and Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Gestational Diabetes Mellitus (GDM) diagnostic guidelines in Australia. We found piecemeal adoption of recommended changes, with cessation of the 50 g glucose challenge test (GCT) universal, early screening implementation common, but by varied methodologies, and new diagnostic criteria acceptance far from complete with significant workload increases almost universal.

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“…Preeclampsia was defined as systolic blood pressure >140 mmHg or diastolic blood pressure ≥90 mmHg and 24-hour proteinuria ≥0.3 g, started at >20 weeks [39]. Gestational diabetes mellitus referred to glucose intolerance first detected during pregnancy and was diagnosed according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria [40]. Premature rupture of membrane was considered as rupture of the fetal membranes before the onset of labor regardless of gestational age [41].…”

Section: Methodsmentioning

confidence: 99%

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

Rostami¹,

Tehrani²,

Simbar³

et al. 2017

JMIR Res Protoc

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BackgroundAlthough there have been marked improvements in our understanding of vitamin D functions in different diseases, gaps on its role during pregnancy remain. Due to the lack of consensus on the most accurate marker of vitamin D deficiency during pregnancy and the optimal level of 25-hydroxyvitamin D, 25(OH)D, for its definition, vitamin D deficiency assessment during pregnancy is a complicated process. Besides, the optimal protocol for treatment of hypovitaminosis D and its effect on maternal and neonatal outcomes are still unclear.ObjectiveThe aim of our study was to estimate the prevalence of vitamin D deficiency in the first trimester of pregnancy and to compare vitamin D screening strategy with no screening. Also, we intended to compare the effectiveness of various treatment regimens on maternal and neonatal outcomes in Masjed-Soleyman and Shushtar cities of Khuzestan province, Iran.MethodsThis was a two-phase study. First, a population-based cross-sectional study was conducted; recruiting 1600 and 900 first trimester pregnant women from health centers of Masjed-Soleyman and Shushtar, respectively, using stratified multistage cluster sampling with probability proportional to size (PPS) method. Second, to assess the effect of screening strategy on maternal and neonatal outcomes, Masjed-Soleyman participants were assigned to a screening program versus Shushtar participants who became the nonscreening arm. Within the framework of the screening regimen, an 8-arm blind randomized clinical trial was undertaken to compare the effects of various treatment protocols. A total of 800 pregnant women with vitamin D deficiency were selected using simple random sampling from the 1600 individuals of Masjed-Soleyman as interventional groups. Serum concentrations of 25(OH)D were classified as: (1) severe deficient (<10ng/ml), (2) moderate deficient (10-20ng/ml), and (3) normal status (>20ng/ml). Those with severe and moderate deficiency were randomly divided into 4 subgroups and received vitamin D3 based on protocol and were followed until delivery. Data was analyzed according to the intention-to-treat principle.ResultsRecruitment commenced in July, 2014, and as estimated, nearly 3.5 years is needed to complete the study. Results of this study will (1) provide reliable information regarding the prevalence of vitamin D deficiency during pregnancy using universal vitamin D screening approach and (2) determine the beneficial effects of universal screening and compare the various treatment protocols in terms of pregnancy outcomes.ConclusionsSince vitamin D deficiency is a prevalent disorder in pregnancy among Iranian population, this study will ensure creation of reliable evidence-based findings and will enable clinicians to better evaluate and treat vitamin D deficient pregnant women.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 2014102519660N1; http://www.irct.ir/searchresult.php?keyword=&id=19660&number=1&prt=7805&total=10&m=1 (Archived by WebCite at http://www.webcitation.org/6p3lk...

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Impact of the new IADPSG gestational diabetes diagnostic criteria on pregnancy outcomes in Western Australia

Cited by 44 publications

References 22 publications

The prevalence of hyperglycaemia in pregnancy in Australia

The prevalence of hyperglycaemia in pregnancy in Australia

Survey on testing for gestational diabetes mellitus in Australia

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

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